Drugs for life and death We can't get either

In the past year, much has been written about the shortage of critical generic drugs in this country. This has been accompanied by a whole lot of talk, including an executive order from President Obama, basically repeating the same message that previously came from the FDA and congress: That the government can require that companies report an impending shortage or planned cessation of the manufacture of a drug, but cannot force them to make any drug. One effective way of gaining partial control of this mess would be to lure genetic production back to this country. Not a word about this.

Not surprisingly, since my August op-ed in the New York Post, and a brief update here in October, I cannot find any indication that anything concrete has been done. In fact, it may be getting worse.

This can be illustrated by yesterday's rather ghoulish story from Reuter's, pointing out that we are not only out of many life-saving drugs, we are also out of life-ending drugs. Yes--in a rather twisted spin-off of the original problem, the United States cannot execute prisoners because we can no longer buy sodium thiopental--one of the three drugs used in lethal injections. Manufacturers in Europe have decided to refuse to sell thiopental (used to induce unconsciousness), pancuronium bromide (to paralyze muscles and stop breathing) and potassium chloride (to induce heart failure) to the US in protest of the use of the death penalty in this country. Other barbiturates--legitimate anesthetics--are also included in the ban, because they can be used as substitutes for thiopental.

Now, I won't even go anywhere near the ethical or legal merits of execution, or lack therof. But the metaphorical aspect of this story is hard to miss. Not only have we ceded control of our lives to foreign generic companies, but now also our deaths. We have grown so helpless and dependent on others that a few impurities in an IV bag made in China or a social policy in Denmark can determine life and death in America.

Is this really the way we want to live?

Drugs for life and death We can't get either/Medical Progress Today